Articulating suturing device and method
First Claim
1. A method for suturing a puncture through a vessel wall of a blood vessel, the puncture disposed within a tissue tract of a patient body, the method comprising:
- attaching a flexible filament to a first fitting and a second fitting;
inserting a distal end of a probe through the puncture, said probe having a foot, said fitting being releasably mounted near a first end and a second end of the foot;
articulating the elongate foot of the probe within the blood vessel so that the foot moves from a low profile configuration aligned along a shaft of the probe to a deployed configuration extending laterally from the shaft and along the blood vessel, such that the fittings are positioned at opposed sides of the puncture;
forming a needle path by advancing a first needle through the vessel wall outside the puncture;
coupling the needle with the first fitting; and
withdrawing the first needle, the first fitting, and at least a first portion of the filament through the vessel wall along the needle path.
2 Assignments
0 Petitions
Reexamination
Accused Products
Abstract
Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot carries suturing attachment cuffs, and needles are advanced from the shaft through the vessel wall outside of the penetration and into engagement with the needle cuffs after the foot has been drawn proximally up against the endothelial surface of the blood vessel. The cross-section of the shaft within the tissue tract can be minimized by laterally deflecting the needles as they leave the shaft, while tapered depressions within the foot can guide the advancing needles into engagement with the cuffs. The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture. The articulating foot may be realigned with the shaft and withdrawn proximally through the tissue tract without dilating the tissue tract.
774 Citations
38 Claims
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1. A method for suturing a puncture through a vessel wall of a blood vessel, the puncture disposed within a tissue tract of a patient body, the method comprising:
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attaching a flexible filament to a first fitting and a second fitting; inserting a distal end of a probe through the puncture, said probe having a foot, said fitting being releasably mounted near a first end and a second end of the foot; articulating the elongate foot of the probe within the blood vessel so that the foot moves from a low profile configuration aligned along a shaft of the probe to a deployed configuration extending laterally from the shaft and along the blood vessel, such that the fittings are positioned at opposed sides of the puncture; forming a needle path by advancing a first needle through the vessel wall outside the puncture; coupling the needle with the first fitting; and withdrawing the first needle, the first fitting, and at least a first portion of the filament through the vessel wall along the needle path. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A method for suturing an opening in a tissue, the method comprising:
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inserting a distal end of a probe through the opening, the probe defining a probe axis; articulating an elongate foot of the probe so that first and second ends of the foot extend laterally with the opening aligned therebetween; supporting a suture by said first and second ends of the foot; forming a first needle path from the probe through the tissue and to the first end of the foot; forming a second needle path from the probe through the tissue and to the second end of the foot; advancing said suture along the first and second needle paths to position a suture loop across the opening. - View Dependent Claims (15, 16, 17, 18)
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19. A method for suturing a blood vessel, the vessel having a vessel wall, the method comprising:
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advancing a shaft toward the vessel wall, the shaft having an axis and a plurality of needle guides; supporting a suture by two ends of said foot wherein said two ends extend laterally with the opening positioned therebetween; deploying a foot adjacent the vessel wall so that the foot extends laterally from the shaft; advancing a plurality of needles from needle guides of the shaft to the foot to form needle paths through the vessel wall, the needle guides deflecting the needles laterally so that a needle path width is greater than a cross-sectional dimension of the shaft; and advancing said suture along the needle paths to position at least one suture loop across the puncture. - View Dependent Claims (20)
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21. A system for suturing a blood vessel, the vessel having a vessel wall, the system comprising;
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a shaft suitable for insertion along the tissue tract and into the vessel through a puncture; and a shaft suitable for insertion along the tissue tract and into the vessel through a puncture; and a needle having a proximal end and a distal end suitable for forming a needle path through the vessel wall, the needle having a recessed engagement surface adjacent the distal end; a flexible filament; and a fitting releasably mounted on the foot and attached to the filament, the fitting having an opening and at least one tab extending into the opening, the tab securingly engaging the engagement surface when the needle advances through the vessel wall and into the opening so that the fitting and at least a portion of the filament can be withdrawn proximally along the needle path by the needle. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29)
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30. A system for suturing a puncture of a blood vessel within a tissue tract, the vessel having a vessel wall and defining an axis, the system comprising:
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a shaft having a proximal handle and a distal end suitable for insertion along the tissue tract and into the vessel through the puncture; a foot mounted near the distal end of the shaft, the foot having a plurality of needle receptacles extendable laterally from the shaft; a flexible filament extending between the needle receptacles of the foot; a plurality of needles advanceable distally and laterally from the shaft, through the vessel wall outside the puncture, and to the needle receptacles of the foot. - View Dependent Claims (31, 32)
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33. A system for suturing a puncture of a blood vessel within a tissue tract, the vessel having a vessel wall, the system comprising:
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a shaft having a proximal handle and a distal end suitable for insertion along the tissue tract and into the vessel through the puncture; a foot mounted near the distal end of the shaft, the foot having a first needle receptacle and articulatable from a small profile configuration to a large profile configuration by actuation of the handle; a first fitting removably mounted adjacent the first needle receptacle; filament coupled to the first fitting; and a first needle advanceable from the shaft to the first needle receptacle on the articulated foot, the first fitting securely engaging the first needle so that the secured first fitting and at least a portion of the filament can be withdrawn through the vessel wall by the first needle. - View Dependent Claims (34, 35)
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36. A probe for suturing an opening in a tissue, the probe comprising:
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a shaft having a proximal end and a distal end and defining an axis therebetween, the shaft having a size and configuration suitable for insertion through the opening in the tissue; an elongate foot movably mounted to the shaft; an actuator extending along the shaft distally to the foot, movement of the actuator sliding the foot axially and pivoting the foot from a low profile configuration aligned along the shaft to a deployed configuration extending laterally from the shaft; a suture supported by the foot; and a needle advanceable from the shaft through the tissue and to the deployed foot. - View Dependent Claims (37, 38)
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Specification